Chronic kidney disease (CKD) affects more than 10% of population around the world and is associated with significant morbidity and mortality. In most cases, this disease is developed silently, and it can progress to the end stage renal failure, therefore, early diagnosis becomes critical for initiating effective interventions. Routine diagnosis of CKD requires both blood tests and urinalyses in a clinical laboratory, which are time-consuming with low sensitivity and specificity. Surface-enhanced Raman scattering (SERS) is an emerging method for rapidly assessing kidney function or injury. This study was designed to compare the differences between the SERS properties of serum and urine for easy-and-simple detection of CKD. There were 126 CKD patients (stage 2-5) and 97 healthy individuals enrolled in this study. SERS spectra of both serum and urine samples were acquired by a Raman spectrometer (785 nm excitation). The correlation of chemical parameters of kidney function with the spectra was examined using principal component analysis (PCA) combined with linear discriminant analysis (LDA) and partial least squares (PLS) analysis. CKD was discriminated from non-CKD controls by PCA-LDA with a sensitivity of 74.6% and a specificity of 93.8% by serum spectra, and 78.0% and 86.0 % by urine spectra, respectively. The integration area under the receiver operating characteristic curve was 0.937 ± 0.015 (p < 0.0001) for the serum and 0.886 ± 0.025 (p < 0.0001) for the urine. The different stages of CKD were separated with the accuracy of 78.0% and 75.4% by serum and urine spectra, respectively. PLS prediction (R2) of serum spectra was 0.8540 for the serum urea (p < 0.001), 0.8536 for the serum creatinine (p < 0.001), and 0.7500 for the eGFR (p < 0.001), whereas the prediction (R2) of urine spectra was 0.7335 for the urine urea (p < 0.001), 0.7901 for the urine creatinine (p < 0.001), 0.4644 for the eGFR (p < 0.001) and 0.6579 for the urine microalbumin (p < 0.001). In conclusion, the accuracy of SERS evaluation of serum and urine samples compared to clinical biochemical variables of CKD diagnosis in this limited number of patients is similar, suggesting that SERS may be used as a rapid and easy-to-use method for early screening of CKD. This finding requires further evaluation in a large cohort study.

中文翻译：

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EXPRESS：血清和尿液的表面增强拉曼散射特性在患者慢性肾病快速筛查中的比较

慢性肾病 (CKD) 影响着全世界超过 10% 的人口，并且与显着的发病率和死亡率有关。在大多数情况下，这种疾病是默默发展的，它可以发展到肾功能衰竭的终末期，因此，早期诊断对于启动有效的干预措施至关重要。CKD 的常规诊断需要在临床实验室进行血液检查和尿液分析，这既费时又灵敏度和特异性低。表面增强拉曼散射 (SERS) 是一种快速评估肾功能或损伤的新兴方法。本研究旨在比较血清和尿液的 SERS 特性之间的差异，以便轻松检测 CKD。有 126 名 CKD 患者（2-5 期）和 97 名健康人参加了这项研究。通过拉曼光谱仪（785 nm 激发）获取血清和尿液样品的 SERS 光谱。使用主成分分析 (PCA) 结合线性判别分析 (LDA) 和偏最小二乘法 (PLS) 分析检查肾功能化学参数与光谱的相关性。PCA-LDA 以 74.6% 的灵敏度和 93.8% 的血清光谱区分 CKD 与非 CKD 对照，尿液光谱分别为 78.0% 和 86.0%。接受者操作特征曲线下的积分面积为血清的 0.937 ± 0.015 (p < 0.0001) 和尿液的 0.886 ± 0.025 (p < 0.0001)。血清和尿液光谱分离CKD不同阶段的准确率分别为78.0%和75.4%。血清光谱的 PLS 预测 (R2) 为 0。血清尿素 (p < 0.001) 为 8540，血清肌酐为 0.8536 (p < 0.001)，eGFR 为 0.7500 (p < 0.001)，而尿液光谱的预测 (R2) 为尿尿素 (p) 0.7335 < 0.001)、尿肌酐 0.7901 (p < 0.001)、eGFR 0.4644 (p < 0.001) 和尿微量白蛋白 0.6579 (p < 0.001)。总之，在有限数量的患者中，血清和尿液样本的 SERS 评估与 CKD 诊断的临床生化变量相比的准确性相似，表明 SERS 可作为一种快速且易于使用的方法用于早期筛查慢性肾病。这一发现需要在一项大型队列研究中进一步评估。尿尿素为 7335 (p < 0.001)，尿肌酐为 0.7901 (p < 0.001)，eGFR 为 0.4644 (p < 0.001)，尿微量白蛋白为 0.6579 (p < 0.001)。总之，在有限数量的患者中，血清和尿液样本的 SERS 评估与 CKD 诊断的临床生化变量相比的准确性相似，表明 SERS 可作为一种快速且易于使用的方法用于早期筛查慢性肾病。这一发现需要在一项大型队列研究中进一步评估。尿尿素为 7335 (p < 0.001)，尿肌酐为 0.7901 (p < 0.001)，eGFR 为 0.4644 (p < 0.001)，尿微量白蛋白为 0.6579 (p < 0.001)。总之，在有限数量的患者中，血清和尿液样本的 SERS 评估与 CKD 诊断的临床生化变量相比的准确性相似，表明 SERS 可作为一种快速且易于使用的方法用于早期筛查慢性肾病。这一发现需要在一项大型队列研究中进一步评估。在这有限数量的患者中，血清和尿液样本的 SERS 评估与 CKD 诊断的临床生化变量相比的准确性相似，表明 SERS 可作为一种快速且易于使用的方法来早期筛查 CKD。这一发现需要在一项大型队列研究中进一步评估。在这有限数量的患者中，血清和尿液样本的 SERS 评估与 CKD 诊断的临床生化变量相比的准确性相似，表明 SERS 可作为一种快速且易于使用的方法来早期筛查 CKD。这一发现需要在一项大型队列研究中进一步评估。